Endoscopic Measurement of Barrett’s Esophagus Length is Unreliable - A Prospective Comparative Biopsy Study

Egger, K; Meining, Alexander; Werner, Martin; Höfler, Heinz; Claßen, Martin; Rösch, Thomas

doi:10.1055/s-2004-813061

Cited by 6 publications

(9 citation statements)

References 11 publications

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“…Moreover, there have been controversies regarding the reversibility of BE by PPIs 24,25. Amano et al13 reasoned that the difficulty in judging the length of BE26,27 and the diversity of the mucin phenotype contributed to these controversies. In this study, there were no differences in clinical and demographic factors including PPI treatment between the regression and persistence group although the number of patients was small.…”

Section: Discussionmentioning

confidence: 99%

Predictable Marker for Regression of Barrett's Esophagus by Proton Pump Inhibitor Treatment in Korea

Jo¹,

Lee²,

Kim³

et al. 2013

J Neurogastroenterol Motil

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Background/AimsThere has been no report regarding the regression of Barrett's esophagus (BE) by continuous treatment of proton pump inhibitor (PPI). The aim of this study was to determine the regression rate of BE by PPI and predictable markers related to regression.MethodsThirty-five patients diagnosed as BE were consecutively enrolled and most of them took continuous PPI. The 25 patients underwent endoscopic surveillance and received biopsy. If the specialized intestinal metaplasia (SIM) was lost at any point of surveillance and did not recur, the case was regarded as the regression group. The proportion of SIM was graded and the mucin phenotype was decided using immunohistochemistry for MUC2, MUC5AC and MUC6. To assess the cell proliferation indexes and the degree of intestinal maturation, immunohistochemistry for Ki67 and CDX2 were performed.ResultsThe regression of BE occurred in the 11 (44%) patients. The clinical and demographic factors showed no difference between the regression (n = 11) and persistence group (n = 14). The lower grade of SIM (P < 0.001) and gastric predominant mucin phenotype (P = 0.018) were more frequent, and the number of Ki67 positive cell per gland (P = 0.008) and the mean extent of CDX2 (P = 0.022) were lower in the regression group than in the persistence group.ConclusionsThe regression of BE by PPI treatment was frequent in Korea. The immunohistochemical detection of mucin phenotype, grade of SIM, Ki67 and CDX2 expression in Barrett's mucosa could be useful as a predictable marker for regression of SIM in BE.

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Section: Discussionmentioning

confidence: 99%

Predictable Marker for Regression of Barrett's Esophagus by Proton Pump Inhibitor Treatment in Korea

Jo¹,

Lee²,

Kim³

et al. 2013

J Neurogastroenterol Motil

View full text Add to dashboard Cite

show abstract

“…[46][47][48][49][50] Also, C&M criteria for the endoscopic classifi cation of Barrett's esophagus are reliable for LSBE but less reliable for SSBE. 17 However, we have recently shown that the interobserver agreement of endoscopic diagnosis is within a reasonable range for patients with SSBE when the study is performed by the trained and expert endoscopists as in this study.…”

Section: Discussionmentioning

confidence: 99%

Barrett’s esophagus in Japanese patients: its prevalence, form, and elongation

et al. 2008

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“…Lastly, despite consistently using the Prague C and M classification, the accuracy of endoscopic measurements of BE length is debated. A German study of 75 BE patients demonstrated that the mean difference between the endoscopic and histological assessment of BE length was ≥1 cm . A Greek study evaluated measurement accuracy of endoscopists using a plastic mannequin and found that accuracies in measuring lengths ≥2 cm and ≥3 cm were 83% and 94–95%, respectively ( P < 0.05) .…”

Section: Discussionmentioning

confidence: 99%

“…A Greek study evaluated measurement accuracy of endoscopists using a plastic mannequin and found that accuracies in measuring lengths ≥2 cm and ≥3 cm were 83% and 94–95%, respectively ( P < 0.05) . However, a US study validating the Prague C and M classification of BE in clinical practice found that interobserver agreement was 91% for maximum length, 92% for circumferential extent, and 68% for maximum length ≤1 cm, and that BE experts and community hospital endoscopists showed no differences in agreement in length measurements . BE length measurements may vary by 1–2 cm between two endoscopies, which may account for some of the trends seen in our study.…”

Section: Discussionmentioning

confidence: 99%

“…A German study of 75 BE patients demonstrated that the mean difference between the endoscopic and histological assessment of BE length was ≥1 cm. 20 A Greek study evaluated measurement accuracy of endoscopists using a plastic mannequin and found that accuracies in measuring lengths ≥2 cm and ≥3 cm were 83% and 94-95%, respectively (P < 0.05). 21 However, a US study validating the Prague C and M classification of BE in clinical practice found that interobserver agreement was 91% for maximum length, 92% for circumferential extent, and 68% for maximum length ≤1 cm, and that BE experts and community hospital endoscopists showed no differences in agreement in length measurements.…”

Section: Discussionmentioning

confidence: 99%

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Brief report: the length of newly diagnosed Barrett's esophagus may be decreasing

2014

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Few studies have examined the temporal trends of length in newly diagnosed Barrett's esophagus (BE) and arrived at conflicting results. The aim of this study was to identify whether there has been a change over time in the length of BE at the time of diagnosis. This is a retrospective, single-center, observational study from Houston, Texas on newly diagnosed BE between 2008 and 2013. All cases were defined by the presence of endoscopically visible BE and histologic confirmation of intestinalized columnar epithelium with goblet cells. The length of BE was measured using the Prague classification. We examined temporal changes in 1-year intervals in the length of BE at the time of diagnosis. Both the frequency and mean length of BE at diagnosis seemed to decrease over time from February 2008 to July 2013. The proportion of patients diagnosed with BE ≥3 cm per year declined during the study period, while the proportion of patients with BE ≥1 and<3 cm increased, and those with <1 cm remained stable. The mean age and the gender of patients diagnosed with BE ≥3 cm did not differ significantly by BE length or year of diagnosis. The mean length of newly diagnosed BE may be decreasing as a result of a decline in BE ≥3 cm. These observations cannot be explained by changes in age and gender.

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Endoscopic Measurement of Barrett’s Esophagus Length is Unreliable - A Prospective Comparative Biopsy Study

Cited by 6 publications

References 11 publications

Predictable Marker for Regression of Barrett's Esophagus by Proton Pump Inhibitor Treatment in Korea

Predictable Marker for Regression of Barrett's Esophagus by Proton Pump Inhibitor Treatment in Korea

Barrett’s esophagus in Japanese patients: its prevalence, form, and elongation

Brief report: the length of newly diagnosed Barrett's esophagus may be decreasing

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